Comparative Case Study and Analysis of Aggressive Levothyroxine Treatment vs. Selenium Supplementation for Subclinical Hypothyroidism

Subclinical hypothyroidism, marked by elevated thyroidstimulating hormone (TSH) levels with normal free thyroxine (T4) levels, often presents subtly with symptoms such as fatigue, weight gain, and mood changes. This case study examines a 44-year-old woman diagnosed with subclinical hypothyroidism and evaluates two treatment approaches: aggressive levothyroxine therapy versus selenium supplementation. Guided by the American Thyroid Association (ATA) and European Thyroid Association (ETA) guidelines, this analysis compares the efficacy, risks, and benefits of both interventions, considering the patient’s symptoms, TSH level, and lifestyle. The decision to opt for selenium supplementation aligns with ETA recommendations for patients with mild TSH elevation (below 10 mIU/L) and mild symptoms, aiming to address a mild selenium deficiency and avoid immediate hormone replacement. Follow-up and patient education emphasize dietary modifications, regular physical activity, and close monitoring of thyroid levels to assess treatment efficacy and need for potential escalation. This case underscores the importance of individualized care in subclinical hypothyroidism, highlighting the relevance of patient preferences, biochemical evidence, and lifestyle in achieving effective and sustainable management.